A pilot study of quality of life in German prehospital emergency care physicians

Background: Quality of life in patients represents an important area of assessment. However, attention to health professionals should be equally important. The literature on the quality of life (QOL) of emergency physicians is scarce. This pilot study investigated QOL in emergency physicians in Germany. Materials and Methods: We conducted a cross-sectional study from January to June in 2015. We approached the German Association of Emergency Medicine Physicians and two of the largest recruitment agencies for emergency physicians in Germany and invited their members to participate. We used the WHO Q-BREF to obtain QOL scores in four domains that included physical, mental, social, and environmental health. Results: The 478 German emergency physicians included in the study held board certifications in general medicine (n = 40; 8.4), anesthesiology (n = 243; 50.8), surgery (n = 63; 13.2), internal medicine (n = 81; 17.0), or others (n = 51; 10.7). The women surveyed tended to report a better QOL but worse general health than the men. Regarding specific domains, women scored worse in physical health, particularly energy during everyday work (relative risk ratio RRR: 1.98 1.21–3.24). Both men and women scored worse in psychological health than general health, particularly young women. Women were also more likely to view their safety (RRR: 1.87 1.07–3.28) and living place (RRR: 2.51 1.10–5.73) as being poor than their male counterparts. Conclusion: QOL in German prehospital emergency care physicians is satisfactory for the included participants; however, there were some negative effects in the psychological health domain. This is particularly obvious in young female emergency physicians

An inflamed necrotic appendix epiploicum with immediate contact to a non-inflamed appendix vermiformis: a case report

<p>Abstract</p> <p>Introduction</p> <p>Epiploic appendagitis is a rare cause of focal abdominal pain which, depending on its localisation, can mimic a variety of abdominal diseases. We describe a patient with an inflamed necrotic appendix epiploicum with immediate contact to a non-inflamed appendix vermiformis mimicking acute appendicitis. Considering the rare localization, this is the first report of this kind in the literature.</p> <p>Case presentation</p> <p>We present the case of a 50-year-old Caucasian man who presented with classic signs of acute appendicitis. On clinical exam, McBurney and Blumberg signs were positive. Additionally he had fever, leucocytosis (12/nl) and a slight increase in C-reactive protein (1 mg/dl). Based on the clinical presentation, the patient was taken to the operating room to perform an appendicectomy. Surprisingly, we found an inflamed necrotic appendix epiploicum, located immediately on a non-inflamed appendix vermiformis, which was ligated and excised.</p> <p>Conclusion</p> <p>This case report demonstrates that epiploic appendagitis can mimic acute appendicitis on clinical exam and should be considered in the broad spectrum of abdominal disease presenting with right lower quadrant pain.</p

An empirical limit on the kilonova rate from the DLT40 one day cadence Supernova Survey

Binary neutron star mergers are important to understand stellar evolution, the chemical enrichment of the universe via the r-process, the physics of short gamma-ray bursts, gravitational waves and pulsars. The rates at which these coalescences happen is uncertain, but it can be constrained in different ways. One of those is to search for the optical transients produced at the moment of the merging, called a kilonova, in ongoing SN searches. However, until now, only theoretical models for kilonovae light curve were available to estimate their rates. The recent kilonova discovery AT~2017gfo/DLT17ck gives us the opportunity to constrain the rate of kilonovae using the light curve of a real event. We constrain the rate of binary neutron star mergers using the DLT40 Supernova search, and the native AT~2017gfo/DLT17ck light curve obtained with the same telescope and software system. Excluding AT~2017gfo/DLT17ck due to visibility issues, which was only discovered thanks to the aLIGO/aVirgo trigger, no other similar transients detected during 13 months of daily cadence observations of $\sim$ 2200 nearby ($<$40 Mpc) galaxies. We find that the rate of BNS mergers is lower than 0.47 - 0.55 kilonovae per 100 years per $10^{10}$ $L_{B_{\odot}}$ (depending on the adopted extinction distribution). In volume, this translates to <0.99\times 10^{-4}\,_{-0.15}^{+0.19},\rm{Mpc^{-3}}\,\rm{yr^{-1}}(SNe Ia-like extinction distribution), consistent with previous BNS coalescence rates. Based on our rate limit, and the sensitivity of aLIGO/aVirgo during O2, it is very unlikely that kilonova events are lurking in old pointed galaxy SN search datasets.Comment: 3 figures, 2 table

The discovery of the electromagnetic counterpart of GW170817: kilonova AT 2017gfo/DLT17ck

During the second observing run of the Laser Interferometer gravitational- wave Observatory (LIGO) and Virgo Interferometer, a gravitational-wave signal consistent with a binary neutron star coalescence was detected on 2017 August 17th (GW170817), quickly followed by a coincident short gamma-ray burst trigger by the Fermi satellite. The Distance Less Than 40 (DLT40) Mpc supernova search performed pointed follow-up observations of a sample of galaxies regularly monitored by the survey which fell within the combined LIGO+Virgo localization region, and the larger Fermi gamma ray burst error box. Here we report the discovery of a new optical transient (DLT17ck, also known as SSS17a; it has also been registered as AT 2017gfo) spatially and temporally coincident with GW170817. The photometric and spectroscopic evolution of DLT17ck are unique, with an absolute peak magnitude of Mr = -15.8 \pm 0.1 and an r-band decline rate of 1.1mag/d. This fast evolution is generically consistent with kilonova models, which have been predicted as the optical counterpart to binary neutron star coalescences. Analysis of archival DLT40 data do not show any sign of transient activity at the location of DLT17ck down to r~19 mag in the time period between 8 months and 21 days prior to GW170817. This discovery represents the beginning of a new era for multi-messenger astronomy opening a new path to study and understand binary neutron star coalescences, short gamma-ray bursts and their optical counterparts.Comment: ApJL in press, 4 figure